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Subject:
From:
"Jan Barger RN, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 22 Dec 1998 15:41:41 EST
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Nikki said,

<<  In the Cooper study, looking at babies admitted for dehydration and FTT
 which led to serious medical problems, the babies had lost as much as 23% of
 birthweight.
   In a case where more than 10% of weight had been lost in the first week
 after birth, I would be so careful and want to know if the weight loss had
 bottomed out or was going on farther. This gets into a scary area for me. How
 does everyone else feel? Warmly, Nikki Lee >>

I think the point is you look at ALL the parameters.  There is not just one
thing that is going to indicate dehydration or low caloric intake.  You will
see more than one.  If there is >10% weight loss, but the baby is pooping &
peeing and has moist mucous membranes and is breastfeeding and obtaining a
good milk transfer, then why are we concerned?  I would suspect an incorrect
birth weight, or fluid transfer from excessive IV fluids given to the mom.  If
there is <10% weight loss, but the baby isn't peeing and/or pooping, has dry
mucous membranes and/or sunken fontanels, then by gum, this baby needs help,
regardless of the weight loss.

I still think HCPs get dreadfully hung up over weight -- particularly
percentages -- and fail to LOOK AT THE BABY.  It's the same way we approach bf
-- by the numbers.  How many hours apart, how many minutes on each side, blah
blah -- lets LOOK AT THE BABY.  He'll tell you quite politely when he is ready
to eat, and will tell you quite politely when he is finished.  There are rare
cases in which intervention is called for -- for example, in the baby that
would rather eat than sleep; the baby who is not latching correctly, or
whatever.  Numbers are useful, but observation of the baby and the mother, as
well as hands on assessment is much more important.

Jan Barger

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